Vertical Ridge Augmentation: Available Techniques and Future Trends

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Vertical bone regeneration using growth factors
Isabella Rocchietta
The prime dictate prerequisite to predict long-term success for osseointegrated implants is a
sufficient volume of healthy bone at recipient sites. However, a sufficient amount of bone volume is
frequently lacking as a result of trauma or infectious diseases such as advanced periodontitis. A
number of different techniques have been developed to reconstruct deficient alveolar ridges to allow
dental implant placement in either a simultaneous or staged approach. Vertical bone loss in partially
edentulous patients constitutes a major challenge due to anatomical limitations and technical
difficulties. Extra or intra-oral harvesting of autogenous bone constitutes a high degree of patient
discomfort and morbidity, as well as a limited supply.
Advances in tissue engineering may offer solutions that resolve bone volume deficits and soft
tissue defects while at the same time eliminating some of the concerns posed by current techniques.
The recombinant platelet derived growth factor (rh-PDGF-BB) has been extensively used as a
potent regenerating factor in orthopeadics and periodontics with success. The principal aim in hard
tissue regeneration would be to eliminate the need for autogenous bone harvesting and possibly
eliminate the non resorbable membrane.
A pre-clinical proof of principle research was performed by treating severe chronic mandibular
defects to satisfy this aimi. The endpoint goal of bone regeneration in the three dimensions was
accomplished in the specimens treated by means of a deproteinized bovine block infused with rhPDGF-BB. This translates to the possibility to regenerate bone vertically by using a xenograft as a
scaffold infused by a potent growth factor, without the need to harvest autogenous bone or use a
membrane.
Atrophic human alveolar defects were then successfully treated with the same protocol ii.
In conclusion, the future is moving towards an era where less invasive treatment regimes are now
available to minimize complications and side effects of a surgical procedure, decrease patients’
morbidity, increase success rates and decrease technical difficulties. The maturation of tissue
engineering and its application to clinical surgical procedures has helped create a new paradigm.
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